Organization Active NPI

Lemon Bay Dental Care PA

  • Dentist
  • Englewood, FL
National Provider Identifier
1659704203
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN12356 Issued in FL
Legal business name
LEMON BAY DENTAL CARE PA
Practice address
1505 S McCall Rd
Englewood, FL 34223-4876
Phone
(941) 474-2664
Fax
(941) 475-5920
NPI assigned
Aug 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Andrew J Martineau, D.M.D
Title
Owner
Phone
(941) 474-2664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN12356 FL Primary

Addresses

Primary practice location

1505 S McCall Rd
Englewood, FL 34223-4876

Mailing address

1505 S McCall Rd
Englewood, FL 34223-4876
Phone (941) 474-2664

National Provider Directory

National Provider Directory

Locations

1505 S McCall Rd
Englewood, FL 34223
Phone (941) 474-2664

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1659704203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 S MCCALL RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234876",
            "telephone_number": "941-474-2664",
            "fax_number": "941-475-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 S MCCALL RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234876",
            "telephone_number": "941-474-2664",
            "fax_number": "941-475-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEMON BAY DENTAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "MARTINEAU",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-474-2664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN12356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.